Perinatal outcomes in 375 children born after oocyte donation a Danish national cohort study

Capsule:
Children born after oocyte donation have a higher risk of preterm birth and low birth weight than after standard in vitro fertilization, mainly due to the risk of preeclampsia.

Authors:
Sara S. Malchau, M.D., Anne Loft, M.D., Elisabeth C. Larsen, M.D., Ph.D., Anna-Karina Aaris Henningsen, M.D., Steen Rasmussen, M.Sc., Anders Nyboe Andersen, M.D., D.M.Sci., Anja Pinborg, M.D., D.M.Sci.

Volume 99, Issue 6, Pages 1637-1643.e3, May 2013

Abstract:

Objective:
To describe perinatal outcome in children born after oocyte donation (OD) compared to in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and spontaneous conception (SC).

Design:
National cohort study.

Setting:
Danish fertility clinics.

Patients:
Three hundred seventy-five children born after OD during the period 1995–2010.

Interventions:
None.

Main Outcome Measures:
Mean birth weight, mean gestational age, risks of low birth weight (LBW), preterm birth (PTB), congenital malformations, Caesarian section, preeclampsia and admittance to neonatal intensive care unit.

Results:
We found an increased risk of PTB in OD pregnancies. The adjusted odds ratio (AOR) of PTB in OD singletons was 1.8 (95% CI, 1.2–2.69), 2.5 (95% CI, 1.7–3.6), and 3.4 (95% CI, 2.3–4.9) compared with IVF, ICSI, and SC, respectively. The risk of LBW was also increased. The AOR of LBW was 1.4 (95% CI, 0.9–2.2), 1.8 (95% CI, 1.2–2.8), and 2.6 (95% CI, 1.7–4.0) compared with IVF, ICSI, and SC. The risk of preeclampsia was increased in OD pregnancies with an AOR of 2.9 (95% CI, 1.8–4.6), 2.8 (95% CI, 1.7–4.5), and 3.1 (95% CI, 1.9–4.9) compared with IVF, ICSI, and SC. After additional adjustment for preeclampsia, perinatal outcome improved. Among the twins, the difference between the groups was less pronounced.

Conclusions:
OD pregnancies have poorer perinatal outcome than standard IVF and ICSI, mainly due to the high prevalence of preeclampsia.

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